Provider Demographics
NPI:1073952578
Name:DUNSON, LATONYA LAVETTE (CNP)
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:LAVETTE
Last Name:DUNSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LATONYA
Other - Middle Name:LAVETTE
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 746071
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6071
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:1431 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45410-1411
Practice Address - Country:US
Practice Address - Phone:937-348-7001
Practice Address - Fax:937-949-6113
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14446-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0085766Medicaid
OH000000822131OtherBCBS OH
OH5238915OtherAETNA
OH000000822131OtherBCBS OH
OHH209200Medicare PIN
OH0085766Medicaid